The Significance of Diabetes in Seniors

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By Dr. Loy Puckett

Diabetes is a significant medical problem that presents major implications for an individual’s health, and it’s also one of the leading causes of death in the United States. Though individuals of all ages can develop or be born with diabetes, older adults and seniors are among some of the most at-risk populations.

In what follows, we’ll clarify the different types of diabetes. Further, we’ll explore the many risk factors that older adults and seniors experience with diabetes. Finally, we’ll discuss effective treatment and management protocols for seniors with diabetes.

Types of Diabetes

Diabetes is an endocrine condition that affects the way the body processes glucose, an energy substance. Two of the most common types of diabetes are type 1 and type 2.

Type 1 Diabetes

Type 1 diabetes is defined as an autoimmune disorder in which the insulin-producing cells in the pancreas are destroyed by cells of the immune system. This lack of insulin production causes a deficiency in an important hormonal regulator of glucose levels in the body. Type 1 diabetes is the rarer of the two types of diabetes.

Though older adults can possibly develop type 1 diabetes, it is extremely rare. This type of diabetes is most often seen in children and younger adults.

Type 2 Diabetes

Type 2 diabetes is a metabolic condition resulting from resistance to insulin or an inability to create enough insulin to meet the needs for glucose metabolism. Older adults and seniors are at an increased risk of developing type 2 diabetes.

The prevalence of type 2 diabetes increases with age, and it is estimated that 25% of people over the age of 65 have the condition. Several issues contribute to the higher risk of type 2 diabetes in older adults, including a sedentary lifestyle, a diet high in processed and refined foods, and a family history of the condition.

Some of the signs and symptoms of type 2 diabetes include extreme fatigue and lethargy, frequent urination, and blurry vision.

Treatment and Management of Diabetes In Seniors

The management of type 2 diabetes in older adults may differ from that in younger adults due to the presence of comorbidities and the potential for adverse effects of medications. Comorbidities are other medical conditions that an individual may have, in addition to diabetes.

These comorbidities may include hypertension, heart disease, and kidney disease. In older adults, these comorbidities may affect the ability to properly metabolize medications, which can increase the risk of adverse effects of certain diabetic medications.

To address these issues, the American Geriatrics Society recommends a personalized approach to treatment in older adults with type 2 diabetes. This approach takes into consideration the individual’s functional status, comorbidities, and preferences.

The goal of treatment is to achieve and maintain optimal blood sugar control while minimizing the risk of adverse effects and complications.

Monitor for Hypoglycemia

Older adults with type 2 diabetes should also be especially mindful and careful to prevent hypoglycemia. Hypoglycemia occurs when blood sugar levels drop too low and can be a serious complication in the management of diabetes. Older adults may be at an increased risk of hypoglycemia due to the presence of additional medical conditions or based on their use of particular medications. Symptoms of hypoglycemia in older adults may be subtle and may include confusion, dizziness, and fatigue.

To prevent hypoglycemia, older adults with diabetes should regularly monitor their blood sugar levels and adjust their treatment appropriately based on the guidance of a medical professional. It is also important for older adults to have a plan in place for managing hypoglycemic episodes, including having quick-acting glucose available at all times.

The following are two of the most common treatment and management protocols for diabetes in older adults and seniors:

Lifestyle Intervention

Lifestyle modification, including diet and exercise, is the first consideration for treatment of type 2 diabetes in older adults. A healthy diet that is rich in whole foods, such as fruits, vegetables, and whole grains, and low in processed and refined foods can be extremely helpful in achieving good blood sugar control and reducing complications.

The American Diabetes Association recommends at least 150 minutes of moderate-intensity exercise or 75 minutes of vigorous-intensity exercise per week for older adults with diabetes.

In a recent study, a lifestyle intervention plan that included diet and exercise was shown to improve health objectives dramatically in seniors.

Medication

Medications may also be used to treat type 2 diabetes in older adults. The choice of medication will depend on the individual’s specific needs and may include metformin, sulfonylureas, thiazolidinediones, DPP-4 inhibitors, GLP-1 receptor agonists, or insulin.

It is important to carefully monitor blood sugar levels when starting a new medication and follow the advice of a medical professional to adjust the treatment as needed to ensure optimal control.

Final Thoughts

The prevalence of diabetes in older adults and seniors is high, and it is important for individuals in this age group to receive appropriate care and treatment to manage the condition and prevent complications.

Lifestyle modification, including diet and exercise, should be the first consideration in treatment for type 2 diabetes in older adults.